Blog

When Stress Is The Problem

How many holistic healing practitioners have you encountered who piously urge you to ‘eliminate stress’? You’re not ‘living the life’ unless you’re ‘free from stress’!

Just makes you want to smack ‘em.

Because stress happens. If your life is entirely free from stress, you’re either a sociopath or you’re dead. You can eat healthy, exercise, meditate, get counseling, get a better job, live a ‘soul-centered life,’ and you are still no more immune to death, disease, anxiety, uncertainty, and sudden traumatic upheavals than anyone else. A huge problem with New Age evangelists is that they try to use their beliefs, habits and mantras as talismans against evil–if I just chant ‘Love is Everywhere’ often enough, everyone will love me and nobody will ever die!

Recently, dear friends, I left my day job to run my business full-time. In the space of two and a half months I came down with two colds, an ear infection, and lower back spasms that lasted two weeks. Luckily, I do not believe that ‘psychosomatic’ means ‘it’s all in your head, so just Think Good Thoughts!’ I have a realistic understanding of the mind-body connection, which dictates that emotional stress can lead to a less-effective immune system and a hyperactive nervous system, and there’s not always an easy way around it. So I followed my own advice, put my daughter in the stroller and walked for miles and miles. In a little while, the colds, ear infection and spasms cleared up, and I continued evangelizing. ;-)

So I prefer to talk about ‘stress management techniques’ rather than ‘living a stress-free life.’ That way, when you smash into one of life’s brick walls, you say to yourself, “Ah! A brick wall! Let me mix myself an iced tea while consulting a map,” instead of, “OMG! This wasn’t supposed to happen! I must be a Bad Person! Commence self-flagellation, or flagellation of others!”

I could go off on many Prescriptions for Life, since I’ve been signing up for a whole lot of holistic mailing lists lately, but in order to restrict myself to my purported area of expertise, I will confine myself to a few Tips for Stress-Induced Lower Back Pain.

  • When it’s in the acute stages, try to sleep on your back with a bolster under your knees, and a rolled-up towel behind your neck. This keeps your spine in a neutral position, and allows the spasming muscles to get over their freakout with a minimum of interference.
  • Hydrate. Drink a ton of ice water, lemon water, iced tea and diluted fruit juice. You can intersperse this with strong liquor (great muscle relaxant!) as long as you adhere to the ‘rinse cycle’ principle; one virgin cranberry seltzer for every alcoholic drink you consume.
  • Take it one day at a time. Walk as much as you can. Sit on a yoga ball and bounce; this loosens your hip flexors, which are key in stabilizing your lower back.
  • Get a massage! It won’t fix the pain right away, but it will address the spasming muscles, and send your brain into a theta-wave state which will reduce your stress reactions in the longer term.
  • Go to a yoga class, once the pain is less acute. Yoga will balance your body all over, releasing restrictions far from the area of pain which may be contributing to it.
  • Tylenol won’t kill you if you take a couple. Just don’t make a long-term habit of it.

Massaging the Violin

Science has finally come around to studying massage, sort of:

Massages Ease Low Back Pain – NYTimes.com.

…Each of the massage groups received 10 weeks of treatment, and at the end of that period, all three groups had some improvement, as measured by their answers to 23 questions about performing routine activities without help — for example, climbing stairs without using a handrail or getting out of an easy chair by themselves. They were also asked to rate the degree of their back pain symptoms on a 10-point scale.

Those who received massage scored significantly better on both symptom and function tests, and they spent less time in bed, used less medicine and were more satisfied with their current level of back pain.

As much as this supports my bias, I have a quibble with studies which look at ‘massage’ as a generic unit, as though it were the functional equivalent of taking a pill. All massages are not created equal, just as every body is unique. There’s as much difference between a rub-down by rote and a master massage as there is between a C-major scale and an encore by Itzak Perlman.

Recently I got a Swedish massage at a local spa, courtesy of Groupon. It was a screamingly frustrating experience. The therapist applied some standard moves to the surface of my skin, regardless of whether the muscles underneath were tense, knotted, spasming, or comparatively relaxed. Areas which needed little attention got far too much of it (why spend 10 minutes frictioning the iliac crest? Because it’s there?) whereas the problem spots felt all the worse for having been teased. The aggregate effect was to bring all my imbalances into sharp relief, and leave me feeling desperate for another massage.

This may be an effective marketing tactic, but it sells massage therapy terribly short. A good massage therapist will be able to feel those knots, adhesions and spasms, and perform any number of targeted actions to release them. As I havewritten at length, the area where a client hurts may not be the actual source of the problem; lower back pain can often be traced to restrictions in the legs, hips, chest and even the feet. Although it’s difficult to figure out where these restrictions might be from an initial assessment, it’s pretty obvious once you get your hands on them.

The article goes on to state, “It is unclear how massage eases back pain, but the researchers suggest it may stimulate tissue locally or cause a more generalized central nervous system response.” Hello? How much more vague can you get?Obviously massage is ‘stimulating tissue locally’ and causing a ‘generalized central nervous system response’ (it’s frequently called ‘sleep,’) but if the researchers can’t pinpoint anything more specific than that, there’s a communication breakdown somewhere. Either they’re not asking the massage therapists any questions, or the therapists themselves aren’t clear about what they’re doing.

Why Are Rehab Centers So Ugly? (Part I)

That’s a rhetorical question. I may never know why rehab centers are ugly, because I’m not going to physical therapy school, and you may never understand a system until you’ve worked within it.

While I was researching a career in physical therapy, however, I interviewed at several institutions where physical therapy takes place. I vowed that I would not attempt to redecorate any of the environments in which I found myself, or even bring up the issue; this vow lasted about fifteen minutes.

I used to believe that hospitals, doctor’s offices and cubicles at Pacific Gas & Electric were the nadir of modern working environments, with the exception of meat packing plants and third-world sweatshops. Then I interviewed at X Physical Therapy Center in Philadelphia.

Whoa, nelly.

uglycenter1

The above image is not the center that I visited; it is infinitely nicer. Note the elements of actual color, however frigid; the matching furniture, the plants–possibly not even fake. Flickering fluorescent lights, however: check. Acoustic tile, check. Windowless basement, check. Bare walls, hideous floors, musty odor, uncomfortable furniture, people wearing scrubs: present in force.

If this were a movie set, it would represent an Argentine military prison, circa 1977. Your mind is not clueless–it walks into a place like this and knows you’re about to be tortured. If relaxation is a healing state of mind, you will not achieve it here.

I doubt this is an accident. Why else would they all look like this? Maybe they do it to signify that This Is Serious Medicine, not snake oil, like all that ‘alternative medicine’ BS. Perhaps they wish to demonstrate that they aren’t wasting your premiums on interior design. Possibly the Western healthcare establishment is entirely oblivious to aesthetics.

But, just possibly, it’s about power. Because beautiful places send signals of their own: you are important. You are cared for. You are healthy, wealthy and safe.

tajmajal

Conversely, fluorescent cubicles are where the Little People must work, play, live and die. Ugly=Low Status. It’s as if our culture expects that sick and injured people understand, in their bones, that they are second class citizens. By getting sick, you have sinned. If you want to rejoin society, you must endure Purgatory.

To Talk, or Not To Talk?

’m the first to admit it–chatty clients are fun. Some of my best friends started out as clients who hopped on the table and started a conversation that wouldn’t quit.

Don’t interrupt my meditation!

But this was, and is, always their choice. It is very important to me that my clients have the option of zoning out during their session. I ask questions beforehand and afterward, but I try to keep my comments to a minimum while they’re on the table, unless they initiate the conversation.

This is because an important part of the healing process involves brain waves–specifically, the alpha and theta wavesinduced by deep relaxation. Not only do alpha and theta brain waves increase your levels of beta-endorphin, noroepinephrine and dopamine, leading to greater mental clarity, ability to focus and surcease of pain, they can lead to moments of deep and valuable insight. Being asked a question which forces you to organize your conscious mind can snap you right back into your everyday beta brainwave state. That’s a lot to sacrifice for the sake of idle chit-chat.

This is also why I resist performing therapeutic techniques that require a lot of conscious feedback from my client while the session is in progress. If they come to me complaining of an acute and specific problem, I may ask for their assistance in discovering and releasing particular areas of restriction. But most of the time I can find these areas with my own hands, and work them out using the feedback the body gives me. That way, my client’s mind is free to heal on several levels at once.

‘Self Care for Back Pain’ Free Download!

I’ve written my first e-book. It was a blast. I compiled all my favorite tips for dealing with back pain–neck, shoulders, upper back, lower back–took a bunch of pictures of myself in silly poses, learned some epub software and put it all together. You can download it for free by subscribing to my mailing list.

(I’m using this groovy software called Mail Chimp to manage the list, which allows you to unsubscribe at any time, so you don’t have to worry about getting spammed, and I don’t have to worry about spamming you. This gives me great peace of mind.)

Enjoy!

Things I Didn’t Know

You learn something new every day:

In Women, Hernias May Be Hidden Agony – NYTimes.com.

Unlike hernias in men, which are far more common, those that afflict women are usually small and internal and rarely cause an obvious bulge. Symptoms can be suggestive of other problems — ovarian cysts, fibroids, endometriosis or adhesions from a previous operation — but surgically correcting these conditions does not relieve the devastating pain.

“On average, women go through four prior surgeries, and some a lot more than that, before the real cause of their pain is identified,” said Dr. Deborah A. Metzger, a gynecologist in Los Altos, Calif., who specializes in chronic pelvic pain.

When a woman lies flat on the examining table, the signs and symptoms of a hernia disappear. And the usual exam, an ultrasound, rarely reveals the real problem. Lacking an accurate diagnosis, doctors often send patients to be drugged up by pain specialists and psychiatrists.

Not only is this something to keep in mind, the next time I have a client complaining of intermittent, undiagnosed abdominal pain, it helps to explain a few things.

First of all, when doctors can’t find the source of a problem, they often decide that the problem must be ‘psychosomatic,’ i.e. ‘not real.’ They may not directly say so, but sending a woman suffering from excrutiating abdominal pain to a psychiatrist can be an act of violence in itself. It sends the signal, “I don’t believe you,” and “you must be crazy.”

Second of all, it illustrates a scenario where non-invasive therapies like Reiki could appear to have an effect, however temporary. Lying flat on a table causes the hernia symptoms to disappear, and a treatment which mainly promotes relaxation–and thus the release of abdominal pressure caused by stress–could mask the symptoms for awhile longer.

This doesn’t mean I’m recommending Reiki for hernias. It does mean that I have a some better questions to ask in cases of pelvic pain.

When to See a Doctor

Know your anatomy!You wouldn’t think people would ever get their massage therapist confused with their M.D., would you? You’d be surprised.It’s touching and flattering, how often I am asked for my input on potentially serious medical conditions. Possibly this is due to the fact that 1) I see a lot of people in varying degrees of pain, uncertainty and confusion, 2) I ask probing questions, 3) listen to the answers, and 4) read continually. Finding news of effective treatments for the conditions that plague my clients is one of my joys. I learn as much from them as they learn from me.

However, it ought to be staggeringly obvious that I am not a doctor. Massage and bodywork can be excellentsupplemental treatments for all manner of ills, but they should never be a substitute for comprehensive medical attention. When you have a diagnosis, I’m happy to tailor your session to support your treatment plan, but I know my limits. Here are some of the symptoms that will cause me to refer you for a check-up before I’ll see you again.

  • You have areas of unexplained hypersensitivity, or severe numbness. Since I work on a lot of people, I’m familiar with the range of pain sensitivities in healthy people. If you’re flinching when I touch you lightly in a place that shouldn’t hurt, if you have no feeling in a major limb, or if you insist that I ‘go harder’ when I’m working deeply in an area which should be sensitive, I want you thoroughly checked by a neurologist.
  • You have severe constipation over a long period of time. I once had a client who wanted two-and-a-half hour sessions to address her chronic constipation, but who categorically refused to see a doctor about it. “What could a doctor do?” she asked me, seemingly rhetorically. “Check you for diverticular disease and colorectal cancer,” was my response. It would be irresponsible of me to continue treatment until these possibilities have been ruled out.
  • You have unexplained swelling or bloating in your extremities. “It will go away on its own,” is often what my clients report hearing from their doctors. But if the swelling has no obvious cause, I think you should be tested forheart, liver or kidney problems.
  • You have a suspicious-looking mole on your back. One minor service I provide for my clients is keeping an eye on areas of the body that they don’t normally see. Most people know to visit a dermatologist if they have anirregular mole that changes appearance; if you’ve got one on your back, I always ask if you’ve had it looked at.
  • You suddenly start having migraines. Many of my clients have suffered from migraines for years; they find that regular massage can reduce the frequency and severity of their episodes. But if you’ve never had a migraine before, you should see a doctor before getting a massage.

A doctor’s job is often to do triage in an emergency; my job, as I see it, is not to ‘fix’ a problem, but to facilitate healing over the long term. Massage is less like a drug and more like a tonic–it stimulates the immune system, the parasympathetic nervous system, the endocrine system and the musculoskeletal system to balance and repair themselves. The subtle connections among seemingly disparate systems and processes fascinate me. My clients never have to worry that they’ll bore me, telling me their aches, pains, worries, triumphs, or last night’s bizarre dream. But they also know that they can count on me for the occasional blast of common sense.

What Kind of Massage Should I Get?

The spa menu! Was there ever a thing so enticing, and simultaneously bewildering? ‘Bamboo Raindrop Swedish Scalp Treatment’! ‘Ayurvedic Aromatherapy Deep Tissue Scrub’! ‘Lavender Acupressure Intensive for Neck Pain’! ‘Meditative Earth Massage with Reflexology’? How in the world do you decide which one you need?

The dirty secret is, 90% of all this is marketing. Spas throw together these scrumptious-sounding confections so that they can charge you more money. That’s not to say the massage won’t be worth it; you just can’t tell by the packaging.

Your best bet is to shop around for a therapist who suits you. The technique is only as good as the therapist; anyone who is mechanically applying a particular treatment is not going to perform any miracles. And miracles are what you’re after!

With this in mind, here is your handy guide to deciphering the most common terms on spa menus.

Swedish Massage: This is basic. You take off your clothes, and the therapist rubs you with cream or oil in long, swooshing strokes. It’s nice. If the therapist is following the letter of the law, however, it won’t be much better than nice; if you’ve got a lot of knots, as most of us do, it can be screamingly frustrating. Your therapist will glide right over those festering areas, giving them no more and no less attention than the top of your hip bone. And few people ever get trigger points at their iliac crest.

Deep Tissue: Swedish, only tougher. Your therapist will go after those knots, possibly using elbows; your body will get a workout. However, the joy and relief you get from this is highly dependent upon the skill of your therapist. Some poor souls are imbued with lasting terror of deep tissue, after a ham-fisted masseuse left bruises that stayed for a week. A sensitive therapist will only go as deep as your body allows. If you flinch, tense up or cry out, and the therapist doesn’t immediately back off, don’t go back.

Shiatsu: Shiatsu is an Eastern modality that is traditionally performed on the floor, fully clothed. It involves the mobilization of joints, stretches, and pressure with cupped hands, thumbs and elbows, in specific patterns calledmeridians. Many people swear by it, particularly for back pain. Most Western therapists, however, don’t do straight Shiatsu, partly because it’s hard on their backs, partly because there’s little market for it. An experienced and well-trained practitioner will integrate some Shiatsu moves into a Swedish sequence, insuring that those meridians stay balanced.

Aromatherapy: A serious aromatherapist will interview you closely about your moods, health concerns, stress levels and daily habits before putting together a specific combination of natural essential oils to boost and tone your immune system, emotional condition and spiritual state. If you are getting ‘aromatherapy’ at a spa, this will not happen. It just means that your massage comes with scented oil instead of unscented. Ask to sample the oils before your massage, and ask if they’re natural or synthetic; synthetic oils have no therapeutic properties whatsoever.

Now we come to the more esoteric modalities of massage; the ones that you may reach for if you’re suffering from chronic pain, illness, or undiagnosed disorder that baffles your physician. Some of them may be effective; others may do nothing. Most of them won’t hurt you.

Neuromuscular Massage: This modality focuses on the elimination of trigger points, those areas of acute sensitivity that may radiate down a limb, or up into your skull, causing restriction of movement and chronic pain. A good massage therapist will be able to detect and treat these trigger points during a Swedish/Deep Tissue session, and eliminate them as part of the day’s work.

Since many massage therapists are just going through the motions, however, your chances of getting a thorough trigger-point tune-up are vastly increased if you go to one who explicitly states that they are neuromuscular-capable. At the very least they should be able to tell the difference between a trigger point and a tendon.

Reflexology: This is another Eastern modality that maps the body onto the soles of the feet, and intensively works your feet in order to stimulate healing responses elsewhere. It can be a particularly relaxing treatment if you are too sensitive in other parts of your body to tolerate direct massage.

Craniosacral Therapy: If you’re suffering from chronic neck pain due to whiplash, PTSD, or severe malaise of the nervous system, you might want to give this a try. It is extraordinarily subtle; the therapist places hands on your neck and skull and senses the pulses of your central nervous system, allowing the system to gently balance itself with minimal assistance. The theory is that bones in the skull are mobile, not fused, and the treatment brings these bones into proper alignment.

This theory, however, is controversial. Whatever is objectively happening during a craniosacral session, many clients find it deeply relaxing.

Reiki: This lightest-of-light energy modality is as controversial as it is popular. If you go to a practitioner who integrates Reiki with a more traditional massage session, you can soak in any potential benefits of Reiki while still getting your sore muscles kneaded.

Thai Massage: This is like passive yoga; massage connoisseurs say there’s nothing like it. You lie on a floor mat, and the practitioner bends, stretches and rocks your body in a way which give you a workout without the sweat. Look for an uptick in Thai popularity presently!

Weight Loss, Revisited

Certain Foods Can Aid Weight Loss – NYTimes.com.

Pureed vegetables in your casseroles? Seems devious and mildly depressing, but if you must.

However, Pretty Lady’s advice for joyous weight loss is still relevant, so here it is, virtually unedited.

1. Do yoga.

Yoga, by and large, will not directly help a person lose weight. It does, however, gently balance and nourish the body as a whole, thus relieving pain, toning the system, helping to release toxins, and getting you in shape to tackle a more-rigorous workout.

If you are having trouble standing up out of chairs, if your back hurts constantly, and you cannot touch your toes, it is best to start with Basic Hatha. This will involve moving slowly into mildly contorted poses, and learning how to breathe. Select a teacher who explains things clearly, is anatomically knowledgeable, and does not shame you.

If you are already able to touch your toes, or if you do not suffer from chronic pain and are in relatively competant cardiovascular shape (i.e. you do not start puffing heavily while climbing two flights of stairs), you may start with Bikram. Bikram is the fabled Hot Yoga sequence, popularized by Madonna and Gwyneth. It is a series of twenty-four poses, performed in a sauna-temperature studio, which are designed to flush the entire body of toxins, stimulate each body system in turn, and take years off your age.

Pretty Lady can attest that it works. After her first class, she experienced quite a dramatic toxic–well, this does not bear description. After her first two weeks of classes, she looked five years younger. After her first six months of classes, she was bored silly. Pretty Lady is a dancer by temperament, and repeating the same damn series of poses every day drives her bananas.

So she moved on to Vinyasa. Vinyasa Yoga is basically Hatha, but a bit more challenging, rigorous, and movement-oriented. A good Vinyasa teacher will have you puffing and doing acrobatic stunts in no time.

2. Work out.

If a person is serious about shedding spiritual poundage, however, more than yoga is required. Once you have done enough yoga so that you can stand on one foot and pull the opposite ankle up to your behind without thinking much about it, you may move on to a more cardiovascular workout.

By far the cheapest and easiest of these is running. Running merely requires a good pair of shoes and a world to run in. If you are not enlightened yet, the world is in front of you; do not skimp on the shoes. Good arch supports are a must. Buy another pair of shoes every six months, whether you think you need them or not. Pretty Lady can attest to the horrors attendant upon working out in bad shoes.

Unfortunately, running is also the sport which causes the greatest amount of wear and tear on the limbs, as Pretty Lady can also attest. If you are over thirty, have flat feet, dicey knees, chronic back pain, or wish to avoid these things, take up biking instead. It doesn’t give you either such a dependable endorphin high or quick physiological transformation, but in the long term it allows you to keep your ability to walk.

Speaking of walking: do it. Every day, at every decent opportunity. Take the stairs. Pop round to the corner store. Stroll up to the lake, or round the park. Visit the neighbors. Fie on this driveway-office-driveway-supermarket-driveway culture. Fie, I say.

It is important to discover a workout which gives you joy. If you love swimming, swim. If you love dancing, dance. If you love hiking, biking, fencing, kickboxing, tennis–well, there you go. If you love beating the shit out of people, there are innumerable martial arts studios springing up everywhere.

3. Watch what you eat.

Pretty Lady is not fond of the Denial attitude toward diet. Proscriptions are depressing and ultimately unsustainable. Surrounding your mental landscape with a forest of ‘no’s’ is not, in her opinion, the best way to cultivate a sense of spiritual freedom, joy and possibility.

Instead, concentrate on adding healthy, wonderful, fresh, nutrious, organic foods to your diet. Focus on fresh organic vegetables, salads, fruits, nuts, whole grains, and fish. Go out of your way to use organic extra-virgin olive oil. Variety is key; get a Thai, Indian, or Chinese cookbook and start experimenting. Make French salads.

Pretty Lady must pause here and give her general guidelines for a French salad.

Take one each of: a green, a steamed or cooked or grated vegetable, a cheese, a fruit, and a nut.

Dress with a dressing made up of: extra-virgin olive oil, lemon or lime juice, balsamic, apple cider, or red-wine vinegar,herbes du provence, salt and pepper.

Suggested greens:
arugula
Boston lettuce
red or green leaf lettuce
endive
escarole
kale (use plenty of lemon in the dressing for this.)

Suggested vegetables:
steamed sugar snap peas
haricots verts (or green beans are fine, sort of)
steamed asparagus
beets, boiled or grated raw
grated carrot
tomatoes
steamed or canned yellow corn
artichoke hearts
mushrooms

Suggested fruits:
apples
pears
figs
kumquats
dried cranberries
mandarin oranges

Suggested cheeses:
bleu
goat
manchego

Suggested nuts:
pignola
toasted walnuts
pecans
sunflower seeds

Feel free to mix, match, add, and experiment to your heart’s content. If you cannot find herbes du provence, get organo, basil, marjoram, thyme, and rosemary, and mix them together.

Also, substitute solid white albacore tuna for the cheese, or add anchovies to the dressing.

Once you have got in the habit of including at least one fruit, vegetable, whole grain, and lean protein in each meal, buttressed by modest amounts of olive oil, you will find that such things as chips, doughnuts, cake, cookies, white bread, deep-fried food, greasy meat, sodas, ice cream, and generally bad-for-you things do not disappear, but lose their central importance. You cannot ingest an entire bag of chocolate chip cookies when your system is already knawing on an exquisite French salad, perhaps with a bit of homemade bread, and an espresso for dessert. You may find the room for two or three cookies. But then your system will simply say, “no, thank you. I do not require more cookies. I am Content.”

4. Love people, love what you do, love your life, love yourself.

Overeating and failing to exercise are symptoms of despair and self-hatred, in Pretty Lady’s opinion. They are an attempt to fill a deep internal void with sweet greasy fluff. This is why the sight of an obese person makes Pretty Lady want to cry, rather than sneer. She has been there herself; most of us have. If you find yourself compulsively overeating, look critically at your life, and ask yourself, ‘what do I need that I haven’t got?’ Be honest. Acknowledge the frustration, the rage, the loneliness, the misery, the humiliation. Forgive yourself for feeling these universal human emotions. Acknowledge that you are a child of the universe, and you have a right to be here.

Then get to work rectifying the real problem, and leave the doughnuts behind.